Analysis of Risk Factors Associated with Squamous Cell Carcinoma in the Indian Population.

BACKGROUND: Squamous cell carcinoma (SCC) describes the carcinomatous growth in the oral cavity. Recently, various authors have described increased SCC incidence in the young population. The distribution of SCC shows varied geographic spread, with the highest distribution in Asian countries. AIMS: The present trial was carried out to assess the associated factors that could lead to increased risk of developing oral cancer. MATERIALS AND METHODS: Oral examination was carried out for 21 participants by a dentist and any significant oral lesion or deleterious habit if present, was recorded. The data collected were analyzed. RESULTS: Areca nut was chewed by 47.61% participants (n = 10), smoking tobacco by 76.19% (n = 16), chewing tobacco by 38.09% (n = 8), and consuming alcohol in 9 participants (42.85%). No significant difference was seen concerning age for any factor except alcohol which showed higher intake in the older group where six participants depicted alcohol intake as compared to three participants in the younger group. In participants who chewed areca nuts, 6 participants also smoked tobacco and 1 consumed alcohol. For tobacco chewing, 5 consumed alcohol and 6 also took tobacco as smoke. CONCLUSION: The present study showed that areca nut and tobacco chewing along with alcohol consumption and tobacco smoking increase the risk of developing SCC in the Indian population.

Diagnostic accuracy of dual energy CT in the assessment of traumatic bone marrow edema of lower limb and its correlation with MRI.

BACKGROUND: Bone marrow edema is assumed to be caused as a result of trabecular microfractures that are detected by MRI. As MRI is not widely available in countries like India, this study aims to encourage the use of DECT in detection of bone edema as evidence with comparable efficiency to MRI. AIM: To assess the diagnostic accuracy of dual-energy CT in detecting bone marrow edema in patients of trauma of lower limb and correlate it with MRI. SETTING AND DESIGN: It is a cross-sectional study. MATERIALS AND METHODS: The study included 40 patients of age 15-70 years irrespective of sex. All the patients of lower extremity trauma underwent DECT and MRI evaluation after clinical evaluation. All the images were postprocessed on a work station and were further evaluated by a radiologist. RESULTS: Mean attenuation at fractured site observed by Dual energy CT was found to be significantly higher as compared to that at adjacent site (170.75 ± 33.99 vs. 19.73 ± 22.50 HU). The sensitivity and specificity of dual energy CT as compared to MRI in detecting bone marrow edema were 94.1% and 91.3%, respectively. Of the 40 cases enrolled in the study, agreement of MRI and Dual energy CT was observed in 37 (92.5%). CONCLUSION: Dual energy CT can be an effective alternative to MRI in the detection of bone marrow edema in patients of lower limb trauma. Dual energy CT can also be used in patients in whom MRI is contraindicated.

A Comparative Assessment Between High-resolution Ultrasonography and Field Magnetic Resonance Imaging in Supraspinatus Tear Cases and Its Arthroscopic Correlation.

Background Diagnosis of a supraspinatus tear in patients presenting with shoulder pain is a difficult task and often requires the help of an MRI. However, in recent years, high-resolution ultrasonography (USG) has been utilized as a cheaper yet sensitive alternative. The aim of the study is to provide a comparative assessment of supraspinatus tears between USG and MRI in relation to arthroscopic results. Methods A total of 60 patients with shoulder pain for the last three months or more scheduled to undergo arthroscopic surgery for their shoulder disorder were enrolled; those having any congenital deformity of the shoulder or having any contradiction to an MRI were excluded from the assessment. All the patients underwent high-resolution ultrasonography (HRUSG) and MRI evaluation. Both the USG and MRI findings were correlated with the arthroscopic findings. Results On ultrasonography, 34 (56.67%) full-thickness tears and 22 (36.67%) partial-thickness tears of the supraspinatus were detected. On MRI, 36 (60.0%) were diagnosed as a full-thickness tear and 20 (33.33%) as a partial-thickness tear. After arthroscopy, 36 (60.00%) were confirmed as a full-thickness tear and 20 (33.33%) as a partial-thickness tear of the supraspinatus. For a full-thickness tear, the sensitivity and specificity of USG and MRI were 95.0% and 92.5%, and 85% and 92.5%, respectively. For a full-thickness tear, the sensitivity and specificity of the modalities were 94.4% and 100%, respectively. Conclusion HRUSG and MRI both had high comparable accuracy for detection of a supraspinatus tear, however, HRUSG had an edge over MRI in the detection of a partial tear.

Characterization of Breast Lesions Using a Novel Combined Approach of Ultrasonography and Elastography Prior to Invasive Procedures: Are New Age Modalities Set to Replace the Diagnostic Giant?

Objective The goal of this study was to evaluate the diagnostic yield of B-mode ultrasound and ultrasound elastography used alone and in combination for differentiating breast lesions into benign and malignant. Materials and methods Eighty-five patients were investigated with B-mode ultrasonography and elastography and provided a Breast Imaging Reporting, and Data System (BI-RADS) score based on ultrasonography, strain ratio, and elastography score (ES) based on elastography. Each lesion was then evaluated by a combination method, combining BI-RADS with strain ratio and BI-RADS with elastography score. Each modality was assessed for the successful detection and characterization of the lesion and whether combining ultrasonography B-mode imaging with strain elastography improves diagnosis and is reliable enough to replace invasive procedures such as biopsy that have been the mainstay of diagnosis. Results Of 85 lesions, 23 lesions (27%) were found to be malignant, and 62 lesions (72.9%) were benign. When used alone, BI-RADS had 100.0% sensitivity, 13% specificity, 50% and 100% positive and negative predictive values (respectively), and 72.9% accuracy. BI-RADS results were then combined with strain ratio (SR) and ES. BI-RADS with SR had 91.3% sensitivity, 95.2% specificity, 87.5% and 96.7% positive and negative predictive values (respectively), and 94.1% accuracy. Similarly, BI-RADS with ES had 91.3% sensitivity, 93.5% specificity, 84.0% and 96.7% positive and negative predictive values, and 92.9% accuracy. Conclusions The combination method performs better at diagnosing breast lesions than BI-RADS alone and can be used as an early and preliminary basis for diagnosis and in settings where invasive procedures cannot be performed. Combining strain elastography and BI-RADS also help characterize which lesions are better suited for biopsy, leading to a decline in unnecessary invasive procedures.

Mid-Second Trimester Measurement of Nasal Bone Length in North Indian Population.

OBJECTIVE: Our objective for this study was to establish a reference range of normal fetal nasal bone length (NBL) from 14 to 22 weeks in a North Indian population. MATERIALS AND METHODS: Pregnant women with gestational age (GA) from 14 to 22 weeks undergoing ultrasonography with a single live fetus and no complications in the fetus or mother were selected for the study. The fetal nasal bone was measured in 2060 pregnant women from 2014 to 2018. The measurement was done by the double operator method; three measurements were taken for each woman when her fetus was in the midsagittal plane, and the nasal bone was located between a 45 and 135° angle to the ultrasound beam. We performed follow-up evaluations of all neonates. RESULTS: The rate of growth of the fetal nasal bone during different weeks of gestation is described by an equation where NBL =0.365×GA+ 2.5885, with a fit estimate of R2 = 0.97, P < 0.001. The median NBL increased with GA from 2.9 mm at 14 weeks to 5.8 mm at 22 weeks in a linear relationship. Our results in the North Indian population are similar to those in the South Indian population and differ from those in Chinese and Japanese populations. CONCLUSIONS: The NBL in North Indian fetuses at 14-26 weeks of GA has a linear relationship to the week of gestation.

Rare Variant of Carcinoma Prostate Masquerading as Benign Prostatic Hyperplasia.

Prostatic ductal adenocarcinoma, is an uncommon entity in the spectrum of prostatic carcinoma. Clinically it is different from common prostatic acinar adenocarcinoma. It is usually more aggressive than prostatic acinar adenocarcinoma. We are presenting a case report on prostatic ductal adenocarcinoma, a cystic variant of prostatic carcinoma in a 55-year-old man who complained of obstructive urinary symptoms with mildly raised prostate-specific antigen (PSA). On further evaluation in our radiology department a cystic lesion with enhancing polypoidal soft tissue component was noted in prostatic parenchyma. Histopathology confirmed the diagnosis of ductal adenocarcinoma.

Implications of Early Pregnancy Obesity on Maternal, Fetal and Neonatal Health: Retrospective cohort study from Oman.

OBJECTIVES: This study aimed to determine the prevalence of early pregnancy obesity among Omani women and to review maternal antenatal complications, intrapartum and postpartum events and neonatal complications among such women in comparison to women of normal weight. METHODS: This retrospective cohort study included 2,652 pregnant Omani women who delivered at the Royal Hospital, Muscat, Oman, between November 2011 and April 2012. The patients' electronic medical records were reviewed for antenatal, intrapartum and postpartum data. Body mass index was measured during the first trimester (≤12 gestational weeks) and classified according to the World Health Organization categories. Maternal and neonatal complications were compared between obese women and those of normal weight. Obstetric outcomes in uncomplicated pregnancies were also compared. RESULTS: In the study cohort, there were 901 (34%) obese women and 912 (34.4%) women of normal weight; of these, 440 (48.8%) and 672 (73.7%) had uncomplicated pregnancies, respectively. Obese women had a significantly increased incidence of gestational diabetes (relative risk [RR]: 2.23; 95% confidence interval [CI]: 1.70-2.92; P <0.01), gestational hypertension (RR: 3.04; 95% CI: 1.63-5.65; P <0.01), Caesarean delivery (RR: 1.48; 95% CI: 1.08-2.03; P <0.01), postpartum haemorrhage (RR: 2.10; 95% CI: 1.11-4.10; P = 0.01) and fetal macrosomia (RR: 2.71; 95% CI: 1.21-6.09; P <0.01). CONCLUSION: Approximately one-third of the studied Omani women were obese. These women had a significantly increased risk of various maternal antenatal complications, intrapartum and postpartum events and neonatal complications.

A picture may be worth a thousand texts: obese adolescents' perspectives on a modified photovoice activity to aid weight loss.

BACKGROUND: In an effort to enhance the vividness and personal relevance of a text messaging intervention to promote weight loss among obese adolescents, a modified Photovoice process was evaluated with adolescents in a weight management program. METHODS: Photovoice is a method using photography to generate relevant images and stories from users. Participants were recruited from the Michigan Pediatric Outpatient Weight Evaluation and Reduction (MPOWER) program, a multidisciplinary weight management program for obese adolescents and their parents. Twenty-three adolescents with a mean BMI of 40 were asked to take pictures on three to five randomly assigned weight-related topics, such as "something that reminds you to exercise," and to text them to a research assistant. Adolescents then engaged in semistructured interviews about the experience. Detailed notes of the interviews were analyzed to identify themes. RESULTS: Participants generally provided high ratings of the process, indicating that (1) deciding what pictures to take caused them to reflect on their weight loss experience, and (2) a mobile intervention incorporating personally relevant images (e.g., basketball as their favorite sport rather than sports in general) would increase treatment adherence. The submitted photographs frequently featured family members and friends, and participants indicated that family and friends played a major role in motivating and supporting them. CONCLUSIONS: This study suggests that a Photovoice component has the potential to enhance weight management programs for teens as part of a text messaging intervention and as an independent entity. Further work should evaluate the effect of this promising intervention on weight loss.

Congenital giant melanocytic nevi.

Nevi are common skin tumors caused by abnormal overgrowth of cells from the epidermal and dermal layers of the skin. Most nevi are benign, but some pre-cancerous nevi must be monitored or removed. The giant congenital nevus is greater than 10 cm in size, pigmented and often hairy. Between 4% and 6% of these lesions will develop into a malignant melanoma. Since approximately 50% of the melanoma develop by the age of two, and 80% by the age of seven, early removal is recommended. The objective of this paper is to present a unique case of giant nevi and their surgical management.

Alkylphenol endocrine disrupters inhibit IP3-sensitive Ca2+ channels.

We have investigated the influence of alkylphenol endocrine disrupters and the synthetic estrogen diethylstilbestrol (DES) on inositol-1,4,5-trisphosphate (IP(3))-sensitive Ca(2+) channels from porcine cerebellum and rat testicular membranes. All alkylphenols and DES inhibited the extent of IP(3)-induced Ca(2+) release (IICR) from both cerebellar and testicular microsomes. 4-n-nonylphenol was the most potent compound tested (IC(50), 8 microM). Inhibition of IICR was directly related to the length and hydrophobicity of the alkylphenol side chain. None of the alkylphenols or DES appeared to influence the concentration dependence of IICR nor did they have a significant effect on [3H]IP(3) binding to the membranes. An investigation of the effects of nonylphenol on the transient kinetics of IICR showed that it inhibited the rate constants for both the fast and the slow phases of IICR and also the extent of Ca(2+) release. These results illustrate another mechanism by which these environmental pollutants can disrupt endocrine function without the involvement of estrogen receptors.